Individual provider Active NPI

Lucila Stephanie Green

  • Professional Counselor
  • Austin, TX
National Provider Identifier
1316414485
Registry record updated Oct 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
75674 Issued in TX
Practice address
5015 S Ih 35
Austin, TX 78744-2713
Phone
(512) 804-3200
NPI assigned
Oct 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 75674 TX Primary

Addresses

Primary practice location

5015 S Ih 35
Austin, TX 78744-2713

Mailing address

1430 Collier St
Austin, TX 78704-2911
Phone (512) 472-4357

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240405001464 TX Practitioner - Mental Health Counselor 3173961489 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
75674TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Travis County Mental Health and Mental Retardation Center Professional CurrentSince Feb 25, 2024 Accepting new patients
Austin Travis County Mental Health and Mental Retardation Center CurrentSince Feb 25, 2024 Accepting new patients

Locations

1430 Collier St
Austin, TX 78704
Phone (512) 427-4357

5015 S Interstate 35
Austin, TX 78744
Phone (512) 703-1392

2501 W William Cannon Dr
Bldg 4
Austin, TX 78745
Phone (512) 804-3200

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1540512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540512000000",
    "number": "1316414485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 COLLIER ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787042911",
            "telephone_number": "512-472-4357",
            "fax_number": "512-703-1394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5015 S IH 35",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787442713",
            "telephone_number": "512-804-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "LUCILA",
        "middle_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-26",
        "last_updated": "2018-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "75674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.